Moving away from psychiatric diagnoses, one post at a time

It’s ok not to be ok? Sure. With a HUGE caveat

I am so angry right now I am literally shaking. I probably shouldn’t write when I’m this wound up, but I have to do something because I cannot carry this anger around for the day, not on top of all the other emotion that’s currently going on.

I came across an article in thejournal.ie this morning, the crux of which is just how much work is yet to be done to fix mental health services in this country – referrals not being taken, children being treated in adult wards, medication being offered as a first step over therapy, lack of crisis support……….you should have a read.

I have been banging my head off a brick wall, metaphorically and at times literally, for months now. The last week has been horrendous. I went to my doctor yesterday because I had to talk to someone and I had literally nowhere else to go. There was nothing he could say, nothing he could do, other than give me space to vent and try and chase the hospital to get a definite answer on dbt for me. My husband is scared, and worn out. There’s only so many times he’s going to be able to talk me down off a ledge before he cracks too. My parents have been on the receiving end of more than one distress call. My friends don’t believe me when I tell them I’m going home. I have told my psychiatrist I want to be dead. I’ve told my doctor. For fuck sake, I’ve called my husband at work and told him. How is this fair? How have we been left in this situation?

I drafted a piece the other day which I had hoped to get published but no one is biting, so here it is. I would be grateful if you could share this as far as you can, because enough is enough. I do not deserve to be treated like this. My family do not deserve to be treated like this. My friends should not have to pick up the pieces, over and over and over again. I need my life back. But I cannot do it alone. We cannot do it alone. None of you should have to do it alone either.

(This was written in a calmer frame of mind)

We are making huge progress as a society when it comes to talking about mental health, huge. Slowly but surely, the stigma that surrounds it is being chipped away. There are several well established national campaigns encouraging people to talk, and these are getting a bigger response year on year. It’s fantastic to see.

So where’s the caveat? I write from my own experience. I’m not a mental health professional, but I’ve spent years in the public mental healthcare system in Ireland, and that is where the caveat comes in.

No more than any other illness, there are varying degrees of severity when it comes to mental illness, and I think that’s where the problems arise. Yes, it’s ok to ask for help. Seeking support is the first step towards addressing any mental health difficulty. But what about when that help is not forthcoming? What about when a call to a helpline, or a trip to the gp, is not enough? What about when professional support is needed? The barriers are immense.

First, there’s the cost. Let’s suppose I don’t need psychiatric support, but I very much need to speak to a therapist. However, I’m on a low income. Barrier number 1. I need therapy, but unless I can access a low cost service (which may still be too expensive depending on the scale they use) it’s not an option that’s open to me, so I’ve to find a way to manage on my own. The impact that this can potentially have is far reaching. I may find myself unable to work, further compounding the financial situation and increasing the stress, which in itself has a knock on effect on whatever the original issue was…….you can see how quickly this can spiral out of control.

Let’s take it a step further. I’ve been to my GP, I’ve been fortunate enough to access therapy, but the situation still isn’t improving. I need psychiatric assessment. Barrier number 2. I have two choices – take my chances with the public system, or pay to see someone privately. Going privately was never an option for me, so I can tell you about the public system. In the first instance, unless there’s an emergency trip to A&E, it will most likely involve a lengthy wait, and once I get in, I will be seen by a consultant. Thereafter, I will be seen by a member of the team working under said consultant. The lack of continuity that goes hand in hand with this approach – new doctors at almost every appointment, trying to explain the same issues over and over again, varying opinions – is heartbreakingly frustrating. I’m lucky that in recent months I’ve seen my consultant at every appointment for which I’m ridiculously grateful, but prior to this there were years of rotating doctors asking me to rate my mood over the previous number of months on a scale of 1 to 10. Given that my mood can shift dramatically a number of times in any single day, that’s a question that’s both impossible to answer and profoundly unhelpful.

Again, I must emphasise that I’m writing from my own experience, and I’m at the more severe end of the scale in terms of mental illness. But, I’m far from being the only one.

Barrier number 3. Private therapy isn’t an option. I’ve made it through psychiatric assessment and a very specific form of therapy is recommended. But, there’s a waiting list. A lengthy one, with no guarantee of when a place will be available. So what do I do in the meantime? I dig in. I hang on. I have no one left to tell that I’m not ok, because I’ve followed every avenue that I can. My bad days are horrendous. My bad days I quite literally fight for my life. Yet I’m aware that I’m still one of the lucky ones. I have good friends, and a loving, supportive family who do the very best they can for me, but it’s not enough. More than that, it’s not fair to expect that to be enough.

I don’t want to detract from the incredible work that is being done to get people talking about mental health. It’s absolutely vital, and I’m confident countless lives will change for the better because of it. It’s ok not to be ok? Of course! It’s ok to ask for help? Undoubtedly, and it is 110% the right thing to do. It does somewhat work on the assumption that help is both available and accessible though. That’s the caveat right there. From my perspective at least, it’s quite a big one.

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This article has 9 Comments

I completely and totally agree with you. Telling people that you are suffering doesn’t fix it. We still need the help to be accessible and affordable AND consistent. The consistency is a huge barrier for me. I don’t want to go through the same steps with a different face every time. This is not straight forward like I have a pain in my stomach for the last 6 months. You need a relationship with your doctors and therapists. They need to be able to see that you are answering a question differently this week than you did the last 5 weeks. The changes can be subtle tells but very important. It is great that we can be more open about our issues but we have a very long way to go.

I can access therapy privately however the issue I’m having is that the therapist doesn’t really give me coping skills to deal with issues like mood swings, irritability so I’m left looking up books by myself. I haven’t been diagnosed with BPD-at most, I would say that I have traits but not the entire diagnosis-however I’ve still found DBT helpful. There’s 2 books I’m reading by Blaise Aguirre “Mindfulness for Borderline Personality Disorder” and “Coping with BPD: CBT and DBT Skills to soothe the symptoms of Borderline Personality Disorder”. I’ve no advice on your current dilemna however these 2 books might be of some use to you 🙂

Thanks so much, the mindfulness one is on its way to me as we speak 🙂
Have you talked to your therapist about coping skills? If they’re not in a position to help, maybe a different therapist would be better, would you consider changing? And obviously discuss this with your current therapist before making any decisions!!

Fiona,
I attended a private psychiatrist for the past two years. He charged €200 per session, which would last for ten, maybe twenty minutes. My husband was working 50 hours a week to keep myself and our three children afloat. On my last, and final visit, said psychiatrist prescribed me two meds which when taken together would have given me serotonin syndrome. If it wasn’t for the sharp eyes of a newly qualified pharmacist .. I am so so angry and fed up with this. It’s hard enough to try and manage GAD and depression without this shit. I really hope that if we make enough noise someone will hear us. I salute you for all you have done so far, you give me hope and purpose. I ain’t hiding the fact that I have been, and will be, mentally ill. Thank you x

hope you get sorted asap.
unemployed at the mo (trying desperately to get work) and paying for low cost counseling, which is a great help. I asked my GP get me into the public system and she said there was no point as it would take a year to see a psychiatrist.
the politicians in this country should be ashamed of themselves!!!!
Take Care.

It’s heartbreaking, isn’t it? I thought about going privately a couple of years ago when my own consultant was on leave, and even getting to see a private psych would have taken months. As it was I couldn’t afford it so stayed where I was.
Hope you get work soon, and glad to hear therapy is helping. Mind yourself

I understand totally your frustration – 12 years going to clinic. Different registrar every 6 months. Telling your story over and over because they don’t have time to read the notes. I finally got a little better after having maxed out on Lithium and Cymbalta. Side effects from the meds were – weight gain, memory loss and I became a nightmare to live . with. When I came off in April I got some clarity and realised I had destroyed my life, money woes, house in bits, relationships? I straight away started to try and put things right – too late and too much at once. Then in August – I crashed – pressure of work, trying too hard to fix things – Psych said its not BPD just anxiety. Gave me a sleeping tablet that nearly killed me . I started Hypnotherapy and CBT to try something different it was good but then I had to work away for a while. When I came back I crashed again but harder than ever. Christmas was hell for me and I’ve tried 2 different meds which I have had reactions to. The Psych and registrar seem to be fumbling in the dark and there was no other help available. The Go To places in emergency now are Ring Samaritans or A&E – seriously how can you expect someone with anxiety or depression to survive. Then work realised how bad I was (it’s taken 10 years) and they found a therapist for me. It’s been 4 weeks of talking therapy, but I haven’t seen an improvement yet and I know it’s going to be a year or more . This along with gym workouts , Ruby Wax – Frazzled and Matt Haig – Reasons to Live for are just about keeping my head above water at the moment. This blog and others are also helping me to realise I’m not alone but yet I have never felt as alone even though I have 3 wonderful kids I’m hanging on by my finger nails.